In such a scenario, a starting point would be to change the sunscreen to one that contains only the mineral active ingredients titanium dioxide and/or zinc oxide, which have minimal risk of causing a reaction. These mineral actives also are super-gentle, making them good for use around the eyes and on reddened skin.
Another test would be to reduce the frequency of use. Rather than using every product in your routine twice per day, alternate them, apply one in the morning and the other in the evening.
It can also be helpful to alternate days. For example, instead of using a retinol-based product or a prescription anti-acne treatment every day, try applying these every other day and see how your skin reacts. If reducing the frequency doesn’t improve matters, then stop using the most suspect product (or products) and see how your skin reacts.
Keep a notebook handy so you can record how your skin progresses. Briefly jot down the pros and cons, and what you did differently. Yes, it does take a bit of time, but you can refer back to it later to help you better handle a future reaction.
Although active ingredients or problematic ingredients are typical causes of skin reactions, even basic skincare products like cleansers, toners, or moisturizers can trigger negative skin reactions. In such cases, it usually starts when you introduce a new product into an existing skincare routine or when you begin using a new group of products.
If the reaction is mild, it might be helpful to stop using one of the products and see what happens. If that doesn’t help, stop using another one of the new products and see what happens after a day or two. If that doesn’t resolve the problem, then go back to the previous routine that didn’t cause your skin to react. Sadly, when you reach this point, the hunt for products that won’t cause a reaction starts anew—unless you want to keep using your former products, assuming they’re well-formulated.
Using Prescription Products with Your Skincare Routine
There are many reasons why you may want, or need, to add topical prescription products to your regular skincare routine. For example, if you have stubborn acne, prescription-only medications such as topical antibiotics like BenzaClin or topical retinoids like Differin or Retin-A can make a world of difference.
For wrinkles, Renova, the prescription-strength form of retinol, can be extremely beneficial. Topical medications for rosacea, including MetroCream, Atralin, and Finacea; cortisone creams for eczema; medications such as Calcipotriene for treating psoriasis; or topical acne medications like Tazorac are often the only way to keep these irksome skin disorders under control.
There’s a great deal of research about how topical prescription products work to help different skin disorders and about their potential side effects. Surprisingly, there’s minimal to no information on how you’re supposed to incorporate topical prescription products into your daily skincare routine. After all, you still must clean your face, use a skin-healing toner, protect with an effective sunscreen, apply moisturizers or serums appropriate for your skin type, and, for most people, exfoliate … but how are you supposed to do that and apply prescription products? How does it all work together? Can it work together?
Sadly, there isn’t any agreement among dermatologists as to what non-prescription skincare products you’re supposed to use with your topical prescription-only medications or about the order in which to apply them. Frustrating, huh? Even more shocking is the lack of consensus or suggestions about how to avoid some of the most typical reactions from prescription medications, such as redness, irritation, dryness, and inflammation.
We have pored through massive amounts of research to uncover tips on how you can assemble the most ideal skincare routine for your skin type and concerns—and how to incorporate topical prescription medications into that routine. The goal is to use these topical products consistently because none of them are cures. If your skincare routine causes irritation and inflammation, dryness, or additional problems, you’ll not be able to get the best results or (in many cases) continue to use these helpful medications.
Step 1: Use only gentle water-soluble cleansers. Regardless of the medications you apply, everyone first needs to use a gentle water-soluble cleanser appropriate for their skin type. If the cleanser isn’t gentle, it will cause irritation and dryness, which will only be exacerbated by the medication(s) you apply afterward.
Do not use abrasive scrubs with any topical prescription medications. Most scrub particles create tiny micro-tears on the skin’s surface, which will aggravate the skin condition you have and increase the irritation from the medications you’re applying. If you want a bit of extra cleansing, use a washcloth with a gentle water-soluble cleanser.
Caution: Think twice before using a prescription topical product and a cleansing brush like the Clarisonic. This combination can prove too irritating, especially if you’re also using products like exfoliants, skin lighteners, and serums with retinol.
Step 2: Use a great toner. Most toners are loaded with irritating plant extracts such as witch hazel along with alcohol and fragrance—in one word: Ouch! On the other hand, toners loaded with beneficial skin-repairing ingredients can create the optimal environment on your skin for the medication(s) you’ll be applying.
Step 3: Use an AHA or BHA exfoliant. Most people’s skin reaps incredible benefits from exfoliation. This is true even if used in combination with most topical prescription medications.
Tip: There’s a risk of irritation from exfoliants, so you need to start slowly, initially applying a lower concentration exfoliant once (morning or evening) every three days to see how your skin does, and then increasing the frequency and/or concentration based on how your skin responds. If you experience irritation, and it continues, cut back on the frequency, reduce the concentration, or stop altogether.
Step 4: Apply a serum filled with antioxidants, barrier-repair substances, and other beneficial ingredients. These kinds of ingredients are compatible with almost any topical prescription product.
Note: Many people ask us about using an over-the-counter retinol product, such as a serum, plus a prescription retinoid like Renova. It’s fine to use both; generally, you should apply the over-the-counter retinol product first, followed by your prescription retinoid. Do you need both? No, but some people see greater benefit from the combination, or they simply like to alternate a stronger and weaker retinol product. As with any active ingredient, pay attention to how your skin responds and adjust your routine accordingly. Doubling up on retinol products is too much for some people’s skin—more isn’t necessarily better, and you never want to tip the scale in favor of irritation.
Step 5: Apply your prescription product. This is the best place in your routine to apply your prescription product, especially if it has a cream or lotion texture. If it’s a liquid, apply it after Step 3.
Step 6—DAYTIME: Never forget to apply a moisturizing, broad-spectrum sunscreen rated SPF 30 or greater every day. Protecting your skin from the sun not only prevents signs of aging, but also helps repair skin and helps heal many skin disorders by reducing the underlying inflammation. So, unless your physician says otherwise (which may be the case for those with severe psoriasis), always apply sunscreen.
Step 6—NIGHTTIME: Apply a skin-repairing moisturizer and/or serum every night. Moisturizers and serums work effectively with almost any topical prescription; choose one or both based on your skin type and personal preferences, and apply it around the eyes, too. You can add a separate eye cream if needed.
If you’re also using targeted treatment products, apply these either before your daytime or nighttime moisturizer or, if spot-treating, dab the product on top of your moisturizer, after having already applied your prescription product.
A lot of experts suggest you mix your topical prescription medication with your moisturizer to minimize the risk of dryness or irritation.